A nurse in a prenatal clinic is teaching a group of clients about nutrition requirements during lactation. Which of the following statements should the nurse make?

Choice a reason:
Increasing abdominal pain with a nonrelaxed uterus is not typically indicative of placenta previa. This symptom could suggest other complications such as uterine rupture or placental abruption, which are serious conditions requiring immediate medical attention.

Choice b reason:
Abdominal pain with scant red vaginal bleeding is also not a classic sign of placenta previa. While vaginal bleeding can occur in placenta previa, it is usually not associated with abdominal pain. Pain accompanied by bleeding is more suggestive of other obstetric emergencies.

Choice c reason:
Painless red vaginal bleeding is a hallmark sign of placenta previa. In placenta previa, the placenta covers the cervical os either partially or completely, leading to bleeding when the lower part of the uterus stretches and thins as part of the preparation for labor. This bleeding is typically sudden and painless and can range from light to heavy.

Choice d reason:
Intermittent abdominal pain following the passage of bloody mucus is not characteristic of placenta previa. This symptom could be associated with the normal process of losing the mucus plug as labor approaches or could indicate other conditions but is not specific to placenta previa.

Choice a reason:
A fundus that is palpable to the right of the midline can indicate a distended bladder. After childbirth, the bladder can become distended due to decreased sensitivity, which may be caused by trauma during delivery or the effects of anesthesia. A distended bladder can push the uterus to the side and prevent it from contracting properly, leading to increased bleeding. It's important for the nurse to encourage the client to void to relieve bladder distension and allow the uterus to contract effectively.

Choice b reason:
Less than 2.5 cm of rubra lochia on the perineal pad does not necessarily indicate bladder distension. Lochia rubra is the normal discharge of blood, mucus, and tissue from the uterus after childbirth, and its amount can vary widely among individuals. While heavy lochia can be a sign of postpartum hemorrhage, it is not directly related to bladder distension.

Choice c reason:
Increased thirst in a postpartum client is not a direct indicator of bladder distension. Thirst can be influenced by various factors, including dehydration from labor, breastfeeding, or hormonal changes. While it's important for a postpartum client to stay hydrated, increased thirst alone does not suggest a distended bladder.

Choice d reason:
Frequent uterine contractions reported by the client are not a sign of bladder distension. These contractions, known as afterpains, are normal and occur as the uterus contracts to return to its pre-pregnancy size. While uncomfortable, they are a sign of the uterus working to expel blood and tissue and do not indicate bladder issues.